Rethinking rehabilitation

Embedding person-centredness

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The AUT Person-Centred Rehabilitation Research Centre (PCR)

is a transdisciplinary research centre based in the School of Allied Health

Our aims and purpose

Our core aim is to make a meaningful difference to the long-term health and well-being of people and whānau impacted by injury, illness, or disability through transformative, person-centred rehabilitation research and knowledge exchange.

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We engage in a diversity of research projects. Explore our current mahi on our website.

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Recent Submissions

Access status: Open Access ,
Patient-centred Insights Into Persistent Pain After Total Knee Joint Replacement: A Qualitative Synthesis
(Informa UK Limited, 2026-09-22) Dabhilkar, Saba; Hill, Julia; Lewis, Gwyn N; Bean, Debbie J
Purpose Approximately 10-30% of people experience persistent pain following total knee replacement (TKR). Understanding the long-term experiences of pain post-TKR is crucial for optimising patient-centred care and guiding management. This study aimed to qualitatively synthesise existing research on patients’ lived experiences of persistent pain following TKR. Materials and methods A search strategy was implemented across four databases to identify qualitative studies on patient experiences of persistent pain following TKR. The Critical Appraisal Skills Programme checklist was used for quality assessment. Data from selected articles were analysed using a thematic synthesis approach, involving an iterative process of coding, descriptive theme development, and analytical theme development. Results Eight studies were included in the synthesis, with four analytical themes constructed: (1) Unexpected symptoms and unexplained pain, leading to anxiety and distress, (2) Loss of embodiment, related to foreignness and lack of trust in the knee, (3) Lack of interest from the health system, highlighting the disconnect with healthcare providers, and (4) Facilitating acceptance of pain, describing the personal and healthcare system factors that promote reconceputalisation of pain. Conclusions Several individual and system factors are proposed that may break the cycle of pain and distress and facilitate better outcomes.
Access status: Open Access ,
Using Patient-reported Experience Measures to Evaluate a Community-based Chiropractic Outreach Programme in Rarotonga, Cook Islands
(Elsevier BV, 2026-09-04) Cade, Alice; McCambridge, Alana B; Stevens, Kirk; Baptista, Lisa; Holt, Kelly; Niazi, Imran; Marshall, Paul
Objective Community-based outreach placements provide authentic clinical learning environments yet are rarely evaluated using community-derived feedback. This study assessed an intern-led chiropractic outreach placement in Rarotonga using patient-reported experience measures (PREMs) and routinely collected case-mix data as complementary evaluative indicators. PREMs capture patients’ experience of the process of care and differ from patient-reported outcome measures (PROMs), which assess clinical or symptomatic outcomes. Methods Attending adults were invited to complete a post-visit PREM survey (n=252). Survey responses were compared with intern-recorded case-mix data (n=640; 2,453 encounters). Descriptive statistics and exploratory ordinal logistic regression examined patterns in patient experience, demographic predictors, and similarity between patient- and intern-reported information. Results Patient experience ratings were consistently high, particularly for relational domains (communication and personal manner). Tāne/male gender and symptom chronicity were associated with lower reported comfort and satisfaction. Patient- and intern-reported data showed closely similar patterns overall, suggesting good alignment in documentation practices. Conclusion PREMs data provided meaningful insight into relational aspects of care and, when combined with routine case-mix records, supported pragmatic evaluation of a community-based outreach placement. Findings highlight areas for targeted refinement in communication, expectations management, and documentation practices.
Access status: Open Access ,
Ethnic Differences in Cardiac Rehabilitation Enrolment, Participation, and Mortality: A Retrospective Cohort Study from Auckland, New Zealand
(MDPI AG, 2026-08-12) Marshall, Paul W; McCambridge, Alana; Douglas, Sasha; Kendal-Lindbom, Tia; Marshall, Wendy; O'Sullivan, Michael; Ganesh, Gayatri; Walker, Cameron; Earle, Nikki J; Reading, Stacey; Benatar, Jocelyne; Kingsley, Michael
Background/Objectives: Ethnic inequities in cardiovascular disease and healthcare access are well recognised worldwide, but it is unclear whether these inequities translate into differences in cardiac rehabilitation participation and subsequent clinical outcomes. This study examined ethnic differences in cardiac rehabilitation enrolment, participation, and mortality outcomes within a large multi-ethnic cohort to determine whether the association between rehabilitation exposure and mortality differed across ethnic groups. Methods: This retrospective cohort study included 4940 consecutive patients referred to the Auckland cardiac rehabilitation programme between 2016 and 2023. Baseline characteristics, rehabilitation participation, and all-cause mortality were examined across ethnic groups. Associations with mortality were assessed using multivariable Cox proportional hazards models adjusted for demographic and clinical risk factors. Results: During a median follow-up of 5.6 years, 565 deaths occurred. Cardiac rehabilitation participation differed across ethnic groups (p < 0.001), with lowest participation among Pacific patients (44.3%) and highest participation among Asian patients (58.6%). Among attenders, total session attendance was similar across ethnic groups (p = 0.35). After adjustment, mortality risk was lower among Asian patients (HR 0.58, 95% CI 0.46-0.74, p < 0.001), but did not differ for Māori (HR 1.21, 95% CI 0.86-1.71) or Pacific patients (HR 1.03, 95% CI 0.79-1.36) compared with Europeans. Greater rehabilitation exposure was associated with lower mortality (HR 0.98 per session, 95% CI 0.97-0.99, p = 0.002), and no interaction between ethnicity and rehabilitation exposure was observed. Conclusions: Ethnic differences in cardiac rehabilitation were evident at the level of enrolment, but not in session exposure among attenders or in the association between rehabilitation participation and mortality. This study highlights the importance of distinguishing inequities in access and engagement from the effectiveness of rehabilitation once delivered.
Access status: Open Access ,
ACC Work Capacity Certification of Fitness for Work by Physiotherapists in Aotearoa New Zealand: A Qualitative Exploration
(Physiotherapy New Zealand, 2026-08-03) Meys, Shane; Fadyl, Joanna
Physiotherapists in Aotearoa New Zealand currently play a central role in injury management and vocational rehabilitation under the Accident Compensation Corporation (ACC) scheme; however, they are not permitted to certify fitness for work. With increasing pressure on general practice and inequitable access to timely certification, particularly for Māori, Pacific, rural, and socioeconomically deprived populations, there is growing interest in the option of expanding certification responsibilities. This qualitative study explored stakeholder perspectives on legally enabling physiotherapists to complete ACC work capacity certification of fitness for work. Six participants representing diverse stakeholder groups were interviewed using a semi-structured guide, and data were analysed using reflexive thematic analysis. Four key themes were identified: Challenges within the current certification process; Vulnerable populations are struggling and need better support; Opportunity for physiotherapy to offer a positive solution; and Considerations to support physiotherapy to certify effectively. Participants highlighted physiotherapists’ expertise, availability, and collaborative practice as strengths, and supported legislative change with appropriate safeguards. Findings suggest that physiotherapists are well-positioned to enhance certification processes, improve access and equity, and support better outcomes for injured workers. They also provide discussion around key considerations for professional development and practice. This study provides timely evidence to inform policy and professional practice discussions regarding physiotherapy’s role in ACC certification.
Access status: Open Access ,
Practicings of Person-Centred Care in Physiotherapy
(Wiley, 2025-10-31) Hansen, Louise Søgaard; Fadyl, Joanna; Cummins, Christine; Terry, Gareth; Kayes, Nicola
This article explores the practices of person-centred care in physiotherapy by adopting a complexity-seeking approach. We acknowledge that person-centred care is contextual and produced through relationships, sociomaterial practices and institutional and organisational settings, thus recognising the agency of more-than-human actors. We draw on the concept of practicings, which refers to a constellation of what is said, materialised, routinised and practised. This framework enables us to explore the complex interplay and interrelatedness of factors that constitute person-centred care across various contexts, transcending micro and macro levels. By conducting a secondary analysis of texts from three qualitative studies from Denmark and Aotearoa New Zealand on person-centred care in physiotherapy, we argue that seemingly disciplinary and governing practices can also be understood as practices of person-centred care. Through the application of the practicings concept, we aim to advance sociological constructs of person-centred care. Focusing on the complex network of co-constituting forces allows for a more nuanced analysis of practices of person-centredness in physiotherapy, with applicability to other similar healthcare settings.